Lynchburg City Schools Volunteer Application

Thank you for your interest in volunteering with Lynchburg City Schools. Please complete the volunteer application and submit all information requested. All personal data submitted by applicants is confidential. Including a personal email address in your application will ensure you are informed once your application is approved. As part of standard school safety practices, all volunteers and visitors to LCS must provide a photo ID each time they visit any District facility. For assistance with your volunteer application, please visit the campus where you wish to volunteer.

Sincerely,

Lynchburg City Schools

Personal Information

Legal First Name

Address Line 1

Legal Middle Name

I don't have a middle name

Address Line 2 / Apt # / Building #

Legal Last Name

City

Maiden Name

State/Province/Region

Gender

Postal/Zip Code

Date Of Birth

Phone Number Phone number is required

Affiliation

Preferred Language (for future communications)

Please note: An email will be sent to the email address entered to inform you of the status of your application. If you do not have access to email, please enter colecd@lcsedu.net and a district administrator will call you regarding the status.

Please select the schools at which you wish to volunteer

Please select the functions from the list below. (select all that apply)

Please select the organization(s) on behalf of which you are volunteering (if not applicable, select "None")

Please read the disclaimer below and provide your signature

BY MY SIGNATURE, I CERTIFY THAT I KNOW, UNDERSTAND, AND AGREE THAT ANY FALSE STATEMENT OR OMISSION OF INFORMATION REQUESTED WILL RESULT IN MY TERMINATION AS A SCHOOL VOLUNTEER. I give my consent for J. D. Palatine to conduct a criminal background record search on myself and release any results to the following entity: Lynchburg City Schools, 915 Court Street, Lynchburg, VA 24504.

Social Security numbers submitted by applicants are confidential. All other personal data submitted by applicants may be disclosed in accordance with the Virginia Freedom of Information Act (FOIA), located in § 2.2-3700 et seq. of the Code of Virginia.

Name

Signature

By signing your name you agree to all the above statements. Use the mouse or touch screen to sign.

Thank You

Thank you for submitting your application. Your application is under review, and you will be receiving a status email notifying you of approval or continued review of the application. In the event you do not receive a status email in 5 business days, please contact the District Volunteer Coordinator.

Sincerely,

Lynchburg City Schools